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首页> 外文期刊>Journal of clinical nursing >Subgroups of haemodialysis patients in relation to fluid intake restrictions: a cluster analytical approach.
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Subgroups of haemodialysis patients in relation to fluid intake restrictions: a cluster analytical approach.

机译：与液体摄入量限制有关的血液透析患者亚组：一种聚类分析方法。

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AIMS: To determine whether definable subgroups exist in a sample of haemodialysis patients with regard to self-efficacy, attentional style and depressive symptomatology and to compare whether interdialytic weight gain varies between patients in groups with different cognitive profiles. BACKGROUND: Theory-based research suggests that cognitive factors (e.g. self-efficacy and attentional style) and depressive symptomatology undermine adherence to health protective regimens. Preventing negative outcomes of fluid overload is essential for haemodialysis patients but many patients cannot achieve fluid control, and nursing interventions aimed to help the patients reduce fluid intake are ineffective. Understanding the interaction between cognitive factors and how this is related to adherence outcomes might therefore lead to the development of helpful nursing interventions. DESIGN: Explorative cross-sectional multicentre survey. METHODS: The sample consisted of 133 haemodialysis patients. Data were collected using structured questionnaires. A brief self-report form and data on interdialytic weight gain was also used. Two-step cluster analysis was used to identify subgroups. One-way analysis of variance (anova) or Pearson's chi-square test was used for comparing subgroups. RESULTS: Three distinct subgroups were found and subsequently labelled: (1) low self-efficacy, (2) distraction and depressive symptoms and (3) high self-efficacy. The subgroups differed in fluid intake, but not in age, dialysis vintage, gender, residual urine output or in receiving any fluid intake advice. CONCLUSIONS: Clinically relevant subgroups of haemodialysis patients could be defined by their profiles regarding self-efficacy, attentional style and depressive symptoms. RELEVANCE TO CLINICAL PRACTICE: Based on this study, we would encourage clinical practitioners to take into account cognitive profiles while performing their work. This is especially important when a targeted nursing intervention, which aims to encourage and maintain the patient's fluid control, is introduced.
机译：目的：确定血液透析患者的自我效能，注意方式和抑郁症状方面是否存在可定义的亚组，并比较具有不同认知特征的患者之间的透析间增重是否存在差异。背景：基于理论的研究表明，认知因素（例如自我效能感和注意方式）和抑郁症状会破坏对健康保护方案的依从性。对于血液透析患者而言，预防液体超负荷的负面结果至关重要，但许多患者无法控制液体，因此旨在帮助患者减少液体摄入量的护理干预措施无效。因此，了解认知因素之间的相互作用及其与依从性结果之间的关系可能会导致开发有用的护理干预措施。设计：探索性横截面多中心调查。方法：该样本包括133名血液透析患者。使用结构化问卷收集数据。还使用了简短的自我报告表格和有关透析间体重增加的数据。使用两步聚类分析来识别亚组。方差的单向分析（方差分析）或皮尔逊卡方检验用于比较亚组。结果：发现了三个不同的亚组，并随后标记为：（1）自我效能低，（2）注意力分散和抑郁症状以及（3）自我效能高。这些亚组的体液摄入量有所不同，但年龄，透析年龄，性别，剩余尿量或接受任何体液摄入建议均无差异。结论：血液透析患者的临床相关亚组可以通过他们关于自我效能，注意方式和抑郁症状的概况来定义。与临床实践的相关性：根据这项研究，我们鼓励临床医生在执行工作时考虑到认知特征。当采用旨在鼓励和维持患者体液控制的目标护理干预措施时，这一点尤其重要。

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